Comparative Modeling to Inform Cervical Cancer Control Policies: METRICS PROSPR Supplement Phase 2

为宫颈癌控制政策提供信息的比较模型：METRICS PROSPR 补充第 2 阶段

基本信息

批准号：
10648371
负责人：
Ruanne Vanessa Barnabas
金额：
$ 31.25万
依托单位：
HARVARD SCHOOL OF PUBLIC HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-08 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10648371
关键词：
Address Administrative Supplement Black race Cancer Control Cancer Intervention and Surveillance Modeling Network Cervical Cervical Cancer Screening Clinic Collaborations Communities Data Data Sources Development Diagnosis Discrimination Disease Ethnic Origin Exposure to Future Gender Identity Geography Guidelines Health Health Policy Health Services Accessibility Healthcare Healthcare Systems Incidence Individual Joints Language Disorders Lead Link Literature Malignant Neoplasms Malignant neoplasm of cervix uteri Measures Modeling Morbidity - disease rate Neighborhoods Outcome Pattern Personal Satisfaction Phase Policies Population Process Process Measure Race Recommendation Research Research Personnel Resources Review Literature Rural Screening for cancer Sex Orientation Site Socioeconomic Status Stage at Diagnosis Structural Models Structural Racism Subgroup Testing United States National Institutes of Health Woman Work base cancer health disparity care delivery clinical care clinical practice comparative differences in access digital diverse data evidence base evidence based guidelines follow-up food insecurity health care availability health care settings health disparity housing instability models and simulation mortality multidisciplinary multilevel analysis patient population residential segregation screening screening disparities screening guidelines segregation simulation social socioeconomics therapy design tv watching working group

项目摘要

Project Abstract/Summary Understanding the impact of structural racism and discrimination (SRD) on care delivery in the cervical cancer screening processes and how it may produce disparate outcomes for minoritized communities is challenging for many reasons. Much of the evidence that we use to inform health care decisions lacks diverse representation from both a patient population and a healthcare setting perspective. Researchers now recognize that SRD, not only contribute to health disparities, but also to an inadequate evidence base. The CISNET-PROSPR METRICS Working Group has collaborated to address these issues during our Phase I supplement where we conceptualized how structural and institutional factors can lead to differences in access to care, identifying opportunities (and complexities) for modeling to explore the relative contributions of differences in screening practice among subgroups on disparate cervical cancer outcomes. In Phase II, we propose to quantitatively analyze multi-level data that reflect structural policies from the METRICS sites on cervical screening process measures and outcomes, and use the models to project the health impact of differential cervical cancer screening practices on alleviation (or exacerbation) of health disparities in cervical cancer incidence and mortality. Acknowledging the limited empirical evidence directly associating SRD and intermediate social exposures (ISEs) to cervical cancer screening practice and outcomes, the METRICS and CISNET-Cervical investigators propose to continue their collaboration to (1) test and interpret the influence of selected SRD measures on two screening outcomes; (2) project the impact and contributions of differential patterns of cervical cancer screening, diagnosis, and treatment on disparate cervical cancer outcomes among Black versus all women in the U.S.; and (3) integrate measures of association of SRD or ISEs from METRICS into the CISNET-Cervical models to explore the impacts on observed disparities in cervical cancer outcomes. This work would contribute to the limited existing literature on how to measure and model SRD and ISEs to promote equity in cervical cancer screening.

项目摘要/摘要了解结构种族主义和歧视（SRD）对宫颈癌的护理分娩的影响筛选过程及其如何为少数社区产生不同的结果是具有挑战性的出于许多原因。我们用来通知医疗保健决策的许多证据缺乏多样从患者人群和医疗保健设定的角度来看。现在的研究人员认识到SRD，不仅有助于健康差异，而且导致证据基础不足。 CISNET-PROSPR指标工作组已合作解决这些问题我补充了我们概念化结构和机构因素如何导致访问差异的地方照顾，确定建模的机会（和复杂性），以探索亚组在不同宫颈癌结局的筛查练习中的差异。在第二阶段，我们建议定量分析反映来自指标站点的结构性策略的多层次数据宫颈筛查过程措施和结果，并使用模型来投射健康的影响宫颈癌筛查颈椎诊断疗法（或宫颈健康差异）癌症的发病率和死亡率。承认有限的经验证据直接关联SRD和中间的社会暴露（ISE）宫颈癌筛查实践和结果，指标和CISNET颈研究者建议继续他们与（1）测试并解释选定的SRD措施对两个的影响筛选结果；（2）投射宫颈癌差异模式的影响和贡献黑人与所有女性的筛查，诊断和治疗美国；（3）将SRD或ISE的关联度量整合到CISNET宫颈探索对宫颈癌预后观察到的差异的影响的模型。这项工作将有助于有关如何衡量和模型SRD和ISE的有限的现有文献促进宫颈癌筛查中的平等。